Usability of a Virtual Reality Goggle as a New Diagnostic Device in Ophthalmological Practice

BACKGROUND PRET: (neos) is a novel diagnostic device based on a commercially available virtual reality goggle and has been recently introduced by the company machineMD to serve as a neuro-ophthalmological assessment tool. Although the introduction of innovative devices such as PRET has the potential to improve ophthalmological practice, their clinical practicability and tolerability is not always guaranteed. The aim of this study was therefore to assess the usability and tolerability of PRET.

A 6-week, prospective study was conducted at our institution in 2024. We included both healthy subjects from our institution and patients from the neuro-ophthalmological clinic. Data on demographics, participants' perception, and evaluation of the assessment (measured using a visual analog scale [good, mediocre, poor]), the technician's impression of the device's technical performance, as well as the need for surveillance over the assessment, were obtained via a standardized questionnaire by the same technician. The study was approved by the ETH Zurich Ethics Commission (EK 2024-N-177) and informed consent was obtained.

There were 43 participants included in the study, of whom 39 were healthy subjects from our institution and 4 patients from our neuro-ophthalmological practice. Of the total cohort, 20 were women and the median age was 37 years (range 20 - 84). Overall, 86% of participants rated the device as good. Approximately 70% of participants reported no issues with the assessment, 6.2% perceived the exam as strenuous, and only one felt dizzy (without nausea) during the assessment. From a technician's perspective, PRET performed very well in most cases, with technical difficulties occurring during testing in 16% of cases and either before or after testing in 4% of cases. Of the participants, 49% were left with transient goggle marks after the examination, which was considered an acceptable adverse effect.

In this study, neuro-ophthalmological assessment with PRET demonstrated promising results in terms of clinical practicability and patient tolerance. However, in its current form, PRET is not self-explanatory and requires supervised care by a technician. Further studies are needed to corroborate our findings in a patient-based cohort.